Nd:YAG laser hyaloidotomy in a case of Valsalva retinopathy with premacular hemorrhage

Mete Guler, Ozlem Guler, Burak Bilgin

Abstract

Intraretinal, preretinal, and vitreous hemorrhages in Valsalva retinopathy result from retinal capillary rupture following sudden increased retinal venous pressure from a rise in intrathoracic or intraabdominal pressure. While preretinal hemorrhages may resolve on their own or may be treated with vitrectomy, we report a case of Valsalva retinopathy with a dense premacular hemorrhage which was successfully treated with Nd:YAG laser hyaloidotomy. A healthy 27-years-old man presented with sudden painless visual loss after heavy cement bag lifting. His visual acuity was count fingers in the affected eye. A dilated fundus examination revealed a large dome shaped preretinal hemorrhage. Nd:YAG laser hyaloidotomy was performed at the inferotemporal margin of the preretinal hemorrhage. Within two weeks, the visual acuity improved to 20/20 and there was near complete resolution of the preretinal hemorrhage. Non-visually-significant pigment epithelial injury was noted at the site of the laser application. Nd:YAG laser hyaloidotomy may be a safe and effective therapeutic option in select patients with Valsalva retinopathy with preretinal hemorrhage.